Organization
DR. WIT INTERNAL MEDICINE PROF GERIATRIC CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WIT A JAMRY MD (PRESIDENT)
(314) 367-2727
Entity
Organization
Contact information
Practice address
5621 DELMAR BLVD, #105, SAINT LOUIS, MO 63112-2656
(314) 367-2727
(314) 367-2989
Mailing address
7137 MARYLAND AVE, SAINT LOUIS, MO 63130-4417
(314) 721-0675
(314) 721-2830
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505084103
—
MO
01
—
CG9649
RAILROAD MEDICARE
—
Enumeration date
12/09/2005
Last updated
08/11/2011
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